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New health insurance “transparency data” looks suspiciously wrong

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Re: New health insurance “transparency data” looks suspiciously wrong

#31

Post by maxwell »

JPws_Prntr_Fngr wrote: post #17
candiddevmike wrote: post #3

Everyone assumed there would be malicious compliance here but it's definitely eye opening just how malicious they made it. Speaks volumes for the perceived risk releasing this data, IMO. Still waiting to hear about someone using this data to negotiate down a hospital bill, seems like it's just insurance companies that can weaponize this data for better rates.

> seems like it's just insurance companies that can weaponize this data for better rates. That’s because their negotiating power is mainly due to the size of their buying power, not special knowledge or skills. Health “insurance” is basically the lamest, most economically perverted form of collective bargaining ever.

And why federal governments make the best health insurance carriers.

Brokers, medical billing staff, and other middlemen serve no purpose other than increasing cost (in order for an inefficient, openly colluding private cabal to invest premiums, deny claims, and collect profit) because everybody needs access to medical treatment.

Re: New health insurance “transparency data” looks suspiciously wrong

#32

Post by yamtaddle »

firstlink wrote: post #26
iamerroragent wrote: post #18

Imagine a world where one entity received all the peoples medical bills and was incentived to negotiate for the lowest possible rate from each provider. Imagine the savings alone from reducing a massively overly bureaucratic and complicated system down to just one entity negotiating and paying the health service providers. Just imagine in that world this article would have never needed to have been written.

> was incentived to negotiate for the lowest possible rate from each provider So, not an entity which by its very nature spends other people's money and can never run out? I agree, sounds like a great idea, but someone will have to invent such an entity first. The ones we have would not meet the requirement.

Thank god no-one's tried, I'm sure the population of any such country would riot to reform to something free-market-based instead in short order, because expenses would rapidly grow out of control, vastly in excess of, say, what the US spends per-capita, and service would be completely terrible, leading to plainly-worse-in-every-way outcomes than in countries that retained more-enlightened systems.

... what's that? The entire OECD has more centralized government control of healthcare than the US, ranging from extensive price controls, to de-facto or de-jure monopsony, to outright direct control of the healthcare system, and nowhere is there a strong populist movement to ditch that for a heavily free-market-based solution? And literally all of them are way cheaper per-capita than our system? And outcomes remain between pretty-good and great? And instead of the bureaucratic billing mess we have, that's all nice & simple and takes up almost none of the time of sick people and their families? This makes no sense, I read several columns on mises.org proving from first principles that this is impossible!

Re: New health insurance “transparency data” looks suspiciously wrong

#34

Post by civilized »

aintgonnatakeit wrote: post #10

There are two problems here: 1) Hanlon’s razor 2) The author doesn’t understand health insurance data. I’m not trying to excuse the other bad behavior, but within the data itself, he’s experiencing a combination of health insurers’ incompetence, the kludged up data models they’ve had to build to represent the output of the multiple generations of claims processing systems and other administrative processes, and the g…

The point of the author's exercise is to see if the requirement of public transparency enacted by Congress actually means anything.

If the meaning of these prices is only decipherable by an elite priesthood that is too busy to work on the problem, there is no real public transparency.

Re: New health insurance “transparency data” looks suspiciously wrong

#35

Post by Ensorceled »

seventytwo wrote: post #22
aintgonnatakeit wrote: post #10

There are two problems here: 1) Hanlon’s razor 2) The author doesn’t understand health insurance data. I’m not trying to excuse the other bad behavior, but within the data itself, he’s experiencing a combination of health insurers’ incompetence, the kludged up data models they’ve had to build to represent the output of the multiple generations of claims processing systems and other administrative processes, and the g…

Hanlon’s razor? Really? Across multiple actors each with motivation and means to act maliciously? Riiiiiight…

I really wish we could effectively apply Hanlon’s Razor in these cases and force the CEO and board of directs to literally chose between "are you and your CIO malicious" or "is your CIO so grossly incompetent that you have utterly failed in your fiduciary duty"

Re: New health insurance “transparency data” looks suspiciously wrong

#37

Post by nradov »

chatmasta wrote: post #12
csnover wrote: post #11

Earlier quoted context omitted.

GPT-4 readily hallucinates data[0], so that seems unlikely, though it also appears unlikely that it would make it any worse! [0] https://news.ycombinator.com/item?id=34775853

GPT-4 can write queries if you give it a schema, but I definitely wouldn't rely on it to generate any actual data.

The government has a databases of synthetic medical insurance claims that developers can use for testing.

https://www.ahrq.gov/data/innovations/syh-dr.html

Re: New health insurance “transparency data” looks suspiciously wrong

#39

Post by ecommerceguy »

JumpCrisscross wrote: post #30

How catastrophic would requiring hospitals honor their transparency pricing be to the system?

Most hospitals have provided flat files, phase 2, and now the current administration has decided not to enforce this through completion of phase 4 fully searchable due next year. Enforcement began with the previous administration fwiw.

Re: New health insurance “transparency data” looks suspiciously wrong

#40

Post by ecommerceguy »

SamoyedFurFluff wrote: post #14

If anyone is interested, the arm and a leg podcast covers how people leverage transparency data and other strategies to fight hospital bills. Most recently it was covered that so few people take hospitals to small claims court over their billing practices that hospitals can afford exorbitant teams of lawyers to establish more case law that their behavior is legal. https://armandalegshow.com/

There used to be, and I'm not in a position to find it, a forum that specialized in cash paying the least amount for all procedures, lab tests, imaging etc.

It truely was impressive how these forum members unearthed massive savings and really, once you knew what to do, didn't seem all that invasive or difficult.

We are writing more groups using Referenced Based Pricing. Good idea.

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